| NPI | 1356519037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY ROBERT GOMOLUCH Owner 989-397-6055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2008-02-14 |